Short-term and long-term outcome of hemolytic uremic syndrome in Iranian children.
BACKGROUND
Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure during infancy. Many symptoms and clinical features have been proposed as prognostic factors for HUS in the short and long term, while the results of different studies have often been controversial. The aim of this study was to evaluate short-term and long-term outcomes of HUS in Iranian children.


METHODS
Medical records of all 92 children suffering from HUS admitted to the pediatrics nephrology ward at Ali-Asghar Children Hospital in Tehran, Iran, from 1990 to 2004, were retrospectively reviewed.


RESULTS
Out of 92 children, mortality was observed in 18 patients (19.6%) during the acute phase of the disease. Significant correlation between mortality and seizures, coma and hypertension in the acute phase was found (p<0.05). No association was observed between type of treatment and mortality (p>0.05). In the long-term, the presence of hypertension in the acute phase of the disease (p=0.023; relative risk [RR] = 3.89; 95% confidence interval [95% CI], 1.01-13.76), hypertension at discharge time (p<0.001; RR=10; 95% CI, 2.44-40.91) and need for dialysis (p=0.021; RR=1.38; 95% CI, 1.13-1.70) were shown to be significant risk factors for future hypertension in HUS patients.


CONCLUSIONS
Central nervous system involvement is associated with mortality in the acute phase of HUS, whereas the severity of disease in the admission phase is related to occurrence of hypertension in future.
Otukesh
Hasan
H
Ali-Asghar Children Hospital, Iran University of Medical Sciences and Health Services, Tehran - Iran. hasanotukesh@yahoo.com
Hoseini
Rozita
R
Golnari
Pedram
P
Fereshtehnejad
Seyed-Mohammad
SM
Zamanfar
Daniel
D
Hooman
Nakissa
N
Tabarroki
Ali
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000150:complications; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000401:mortality*; D006801:Humans; D006973:Hypertension / Q000150:complications; D007223:Infant; D007492:Iran; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012640:Seizures / Q000150:complications; D016019:Survival Analysis; D015996:Survival Rate